Index

The Survival of "Global Health" - Part Five: The Global Food Supply

What could be more fundamental to human health than food? Having
enough of it, and having the right kind?

In early childhood an insufficient diet leads to stunted growth and
neurological issues, including mental retardation. Later in life the effects of
years of consuming the wrong calories, and missing sufficient vitamin and
protein targets take their toll producing everything from diabetes and heart
disease to osteoporosis and cancer.

As the real estate and stock bubbles expanded in late 2007, worried
investors cast about in search of safer havens for their wealth. In the final
quarter of the year, food commodities markets witnessed an unprecedented surge in the volume of investment, particularly in crop
futures markets, and in the speed of investment cycling. High powered hedge
funds and speculation investment companies raced into churning reckonings on
the forecasts for rice, wheat, corn, soybeans, and other essential grains. The
UN’s Food and Agriculture Organization (FAO) watched helplessly as basic grain
prices rose alarmingly, reaching a crisis in December 2007 when India capped
all rice trade, hedging against a global crisis.

The world rice market responded with instant inflation,
spawning yet another Indian hording edict, followed by similar action by the
Vietnamese government. By March of 2008 rice prices had risen as much as 200
percent in parts of Asia, riots broke out in several countries, and the World
Bank said more than 100 million people had been driven back into subsistence
poverty.

Since 2008 the world has faced three more food inflation crises,
and though prices have come down after each, they have reset at a “new
normal” that is higher than each successive
pre-crisis pricing. In other words, food is on an upward trajectory, though in
roller coaster fashion.
The FAO predicts an unstoppable inflationary trend, mitigated only by careful
policies that may stave off famines and global malnutrition. Clearly access to
appropriate, nutritious food is essential to human health, but to date the
global health architecture has failed to absorb food issues in any but a
rhetorical fashion. Harmonizing long term strategies and planning with major
food and development programs would seem wise, bringing such entities as OXFAM,
WHO, FAO, World Bank and thousands of food-related humanitarian and NGO groups
into a shared vision. But no such drive has emerged in practical terms.

There are multiple drivers behind food price inflation, variously amenable to
mitigation. Global health advocates should understand these trends and work as
allies with food and agriculture organizations to achieve reasonable food security
protections for the nine billion food consumers of the mid-century. Some of the
causes of food inflation are also drivers of the leading sources of poor
health, and therefore constitute obvious shared targets.

Prior to the 2008 first food inflation crisis, the George W.
Bush administration legislated significant subsidies, luring American corn
growers to divert crops for biofuels/ethanol production. The outcome was
overproduction of corn, at the expense of cropland use for other foods, and
diversion of some 40
percent of U.S. corn to fuel gas tanks
instead of stomachs. So feverish was the pace of corn cultivation for ethanol
that American Midwest farmers depleted
groundwater supplies, pumping more than 30 feet down the region’s primary
aquifer in merely four years’ time, and turning vast expanses of Kansas, Texas,
Oklahoma, Nebraska and Iowa into agricultural
wastelands. Even as corn production rose, stocks of edible supplies
plummeted. Similar climate change mitigation efforts have unfolded across
Europe, resulting in wider use of arable lands for ethanol production, and
declines in food crop yields. The BRICS nations, particularly Brazil and China, are also diverting cropland to ethanol
production, and buying
up arable resources in poorer countries for
large-scale plantings of sugar cane, rapeseed, corn and other crops easily
converted to ethanol fuel. The world was increasingly growing crops for fuel
tanks, not human tummies. Cereal productivity
is up, but so are demand and ethanol diversion.

Net food demand is rising alongside both human population
increase and relative prosperity.

Not only are there ever more mouths to feed, but more of the
hungry are able to pay for their food, and demand a diverse diet. On the
overall demand side there is debate in agricultural development and investment circles
regarding the global capacity to produce food, amid declining water resources,
shrinking arable lands, climate change-induced temperature shifts and the slow
pace of modernization of farming practices. Africa, in particular, shows
striking inability to improve the basic conditions of farming, and the Indian
subcontinent remains extraordinarily inefficient and wasteful in its inability
to get crops to marketplaces in a timely fashion. According to FAO, productivity (measured as tons of cereal
harvested per acre) jumped in the United States from just under 1 ton in 1961
to almost 3 by 2009 – a tripling in productivity. China soared from 0.5 tons in
1961 to 2; Europe from 0.5 to 1.5 tons. Even India has doubled its crop
productivity since 1961. But African productivity has barely budged, remaining
at less than half a ton per acre in 2009.

The G20 recognized the food inflation crisis in its 2009
L’Aquila Summit, reaching a series of resolutions aimed at improving
agricultural development and standards of foreign assistance, especially for
Africa. None of the L’Aquila
commitments on food investment were
realized as promised.

In addition to there being more mouths to
feed, the rise in prosperity links directly to meat and net caloric consumption. According to FAO the Chinese average diet has more than doubled its net
caloric intake since 1980, with 59 kg per capita in the form of meat consumed
in 2005, versus 13 kg in 1980. The World Bank has demonstrated a direct
correlation between per capita income levels and meat consumption in every
major country in the world except Japan and Norway – both, predominately
fish-eating cultures. Rising demand for meat places greater strain on cereal,
land and water resources further exacerbating efforts to increase crop
production for human consumption.

Increasing meat demand has at least two direct impacts on human health. First,
consumption of fatty red meats is associated with cardiovascular disease,
primarily through their contribution to increasing LDL cholesterol levels. And
“monoculture” livestock practices, in which genetically bred cows, chickens,
swine or other animals are raised in captivity in claustrophobic settings,
promote emergence of microbial diseases, particularly in drug resistant forms.
The 2009 H1N1 zoonosis spread from American swine factory-farms, and control of
the H5N1 avian flu virus is hampered by poultry practices throughout Asia.
Multiple studies have demonstrated that widespread use of antibiotics as growth
promoters in the livestock industry is the primary driver of emergence of
drug-resistant bacterial diseases in human beings. Such bat viruses as SARS and
Nipah have spread to humans via livestock animals and live animal markets.

There are many places in the current Global Health architecture where food
security fits in, from provision of crops for AIDS orphans to iron supplements
for pregnant women. But in truth there is no home for this obviously needed
bridge.

It needs to be found, and quickly.

Meat prices are inflating faster than cereals and grains, and will for the
foreseeable future be the dominant driver of overall food price inflation.
Pressure on cereals and grains diversion to feed livestock will increase.
Combined with the other pressures described above, the food inflation spiral
has become an alluring investment opportunity for commodity speculators,
further driving costs. With each weather related (and probably climate change
associated) disaster that impacts crop yields the commodities markets since
2008 have spiked. Thus, Global health finds its exigencies in confluence with
those concerned about agricultural development and climate change. Thanks in
large part to the efforts of Dr. David Nabarro, working as a special envoy on
behalf of UN Secretary-General Ban Ki-Moon, strong bridges between food,
veterinary and health multilaterals have been maintained to counter the threat of zoonotic emergence of
pandemic diseases, such as H5N1 bird flu, SARS and drug-resistant bacterial
infections. Learning from, and building upon, these successes would seem an
obvious first step toward practical, meaningful collaboration across sectors
for life-saving food and agricultural policies and actions.

Finally, the same pressures on the global ecology that are
promoting emergence of human and animal pathogens are wreaking havoc with the
agricultural world. Among the most worrying is a new mutant form of wheat rust,
dubbed Ug99, that first emerged out of eastern Africa a decade ago, quickly
spreading across the Middle East and into Asia. It has mutated recently into an
even more virulent form with a gene conferring resistance to pesticides,
rendering this a plague of potentially Biblical proportions for wheat crops.
Though control methods of crops versus people and animals differ, the roots of
emergence and their predictability have much in common, offering another
potential bridging point.